The other day we were talking about some shockingly unhealthy fast food meals including the “Chicago Classic” at Unos that contains 2,310 calories. It’s worth noting, however, that the reverse also exists. Consider the person, for example, who has an Egg McMuffin for Breakfast, a Big Mac and small fries for lunch, and a Big N’ Tasty With Cheese and medium fries for dinner. That comes out to 1960 calories. According to the Mayo Clinic a 5’9″ 30 year-old man who eats 2000 calories a day can maintain a healthy weight of 150 pounds with a physically inactive lifestyle.
Of course if you switch that up to a Sausage McMuffin, a Double Quarter Pounder With Cheese, and an Angus Delux then it becomes a very different story….
Via Ta-Nehisi Coates it looks like Virginia Governor Bob McDonnell’s flubbing of the Confederate History Month issue early in his term is going to lead to some enduring good:
Virginia Gov. Robert F. McDonnell (R) announced Friday morning that he will declare April 2011 “Civil War in Virginia” month, rather than “Confederate History Month,” as he offered a humble apology for a proclamation this year that omitted reference to slavery’s role in the war.
Maybe we can do something about Jefferson David Highway right across the river from the DC, running conveniently alongside the Pentagon.
The Daily Caller’s Jon Ward reports that there is “pretty widespread” discontent inside the GOP caucus with the recently-released “Pledge to America,” citing the document’s omission of an earmarks ban and its regurgitation of many health reform elements contained in the Affordable Care Act. But, Ward reports, the House GOP leadership was able to restrain much of the internal consternation among its members by circulating a positive editorial written by the National Review.
In the editorial titled “We’ll Take The Pledge,” the National Review editors lauded the document as being “bolder” than the Contract for America. The editorial also called the Pledge “compelling,” “praiseworthy,” and “a shrewd political document.”
Perhaps unsurprisingly, Republican sources told the Daily Caller that the GOP leadership colluded with the National Review in prearranging the editorial:
Two high-level Republican sources said that the National Review editorial had been prearranged, however, by Neil Bradley, a top leadership aide who is close to April Ponnuru, the executive director of the National Review Institute, and Kate O’Beirne, NRI’s president.
“It was a political blowjob,” one Republican aide said of the National Review editorial.
Bradley denied the accusation: “The assertion that I ‘prearranged’ the National Review editorial, or any editorial, is 100 percent false,” he said.
O’Beirne also denied the allegation, calling it “absolutely, categorically false.
In his weekly address, President Obama ripped the “Pledge to America.” “It is grounded in the same worn out philosophy: cut taxes for millionaires and billionaires; cut the rules for Wall Street and the special interests; and cut the middle class loose to fend for itself. That’s not a prescription for a better future. It’s an echo of a disastrous decade we can’t afford to relive,” he said.
The Obama administration’s tax plan—extension of Bush-era tax cuts for all Americans, but non-extension of some Bush-era cuts that exclusively benefit a very wealthy minority—is fiscally responsible only in comparison with the alternative. Which makes me agree with Neil Sinhababu that in some ways this past week’s tax cut muffed punt isn’t the worst thing in the world. Indeed, in many ways the ideal scenario is one in which at least 41 Senators filibuster the Obama tax plan and also at least 41 Senators filibuster full extension of the Bush tax cuts.
Millionaire businessman John Raese is running on a hard-right “pro-business, anti-regulation and anti-tax platform” as the GOP nominee for a Senate seat from West Virginia. Despite having been rejected by the state’s voters three times — including once for the same Senate seat just four years ago — Raese is hoping to capitalize on the right’s current anti-government hysteria.
A self-described “flamboyant businessman,” Raese enjoys the finer things, owning over 15 cars, boats and motorcycles, and a home in Florida where his family lives full-time. But Raese is humble too, acknowledging that he didn’t earn all of that: “I made my money the old-fashioned way. I Inherited it,” he joked in a recent interview. “I think that’s a great thing to do,” he added.
Indeed, in a separate interview with right-wing radio host Laura Ingrham, Raese credited his grandmother with starting Greer Industries, the steel and limestone producer that he now runs. Raese looks back on the business climate of her era at the turn of the century with great fondness, saying he wishes we had the “opportunity in this country to bring back capitalism in the way my grandmother had” it. Raese bemoans that current regulations mean it “would take a lot more effort” to start his grandmother’s business today than it did at the “turn of the century”:
RAESE: My grandmother. It is what she created and what she did at the turn of the century, it still resonates today, if we would have the opportunity in this country to bring back capitalism in the way my grandmother had those fruits and really enjoyed it. … [C]apitalism the way it should be. [...]
INGRAHAM: Could you grandmother start her business empire today, in this climate?
RAESE: Well, it would be a long long time to do it, and a lot of expensive permits to do it, but knowing my grandmother, she could do it. But it would take a lot more effort that it would at the turn of the century.
Of course, while rolling back a century of labor, environmental, and civil rights regulations might make it easier for Raese, it would be absolutely disastrous for every working American. “Capitalism the way it should be,” as Raese dubbed it, included regular use of child labor, widespread repression of organized labor, virtually zero regulations on workplace safety or fairness — including racial and gender discrimination– and unchecked environmental degradation. “At the beginning of the century, workers in the United States faced remarkably high health and safety risks on the job,” a Center for Disease Control history stated, noting the “large decreases in work-related deaths from the high rates and numbers of deaths among workers during the early 20th century.”
Regardless of whether Raese is actually advocating a return to 1900, warts and all, his nostalgic remembrance of the era reflects a larger conservative attempt to discredit the progressive reforms of the last century that made this country stronger and more equitable.
Yesterday, the National Association of Insurance Commissioners (NAIC) released draft guidelines for how insurers should calculate their expenditures to meet new regulations that require issuers that don’t spend 80 to 85 percent of premium dollars on health care expenditures to send rebates to their customers. These percentages are calculated from a ratio of “health expenditures” to other expenses and since reform became law, insurers have pressured the NAIC to calculate include certain administrative expenses as medical costs, exclude all federal taxes from their revenue (the denominator in the MLR ratio), and allow insurers to aggregate the ratio across plans and markets.
Consumer advocates I’ve spoken to tell me that yesterday’s draft regulations — which are now in an open comment period until October 4 — are somewhat of a mixed bag for all parties involved. On the crucial issues:
- TAXES: NAIC rejected the Congressional Committee chair’s statement that they only meant to allow issuers to deduct those taxes that are specifically related to the Affordable Care Act. It ruled that issuers can exclude all federal taxes but those on investment income.
- DEFINING HEALTH COSTS: NAIC rejected insurers’ suggestion that services like anti-fraud and “utilization review” be included in the definition of “medical expenses,” included other services that have not been traditionally classified as “medical,” and required issuers to substantiate why certain services improve care quality.
- AGGREGATION: Insures wanted the NAIC to calculate their MLRs across different units and markets. This would have allowed insures to group their plans together to mask the low MLRs of some of their plans. The draft guidelines would require issuers to break them down and account for the MLRs separately at every business unit in every state.preventing them from obscuring some low MLR plans.
Insurance commissioners also met with the President on Wednesday to ask that plans in the individual market be allowed several years to comply with the new MLR requirements, something the administration could allow if it believes that immediate compliance could lead to serious market disruption. A large concern here is the state of insurance brokers, whose salaries make up a large portion of non health care related spending. Similarly, two states Maine and Iowa, “have asked for a waiver from the rules until 2014 to give health insurers more time to adapt.”
The regulators hope to finalize the rules at an Oct. 21 meeting in Orlando, Fla., and then the Department of Health and Human Services will have the final say.
Well before the conglomerate Koch Industries plunged $1 million into Prop 23 — a ballot initiative in California to essentially repeal the state’s revolutionary clean energy climate change law AB 32 — the Wonk Room revealed that front groups controlled by Koch had been working to promote Prop 23. Americans for Prosperity, the front group founded and financed by Koch Industries’ executive David Koch, had organized Tea Party rallies in favor of Prop 23 and produced online ads distorting California clean energy. The Pacific Research Foundation, also funded by Koch-run foundations, produced junk studies promoting Prop 23.
Today, Center for American Progress Senior Fellow Van Jones spoke to ThinkProgress about Prop 23 and the oil interests polluting the energy debate. Asked about the influence of Koch in supporting Prop 23, Jones slammed the company for “trying to shove” its politics on California. To respond to the Tea Parties and other radical right groups, many of which have been organized by Koch and big business fronts, Jones encouraged the public to “stay involved and to get involved,” because otherwise the people “screaming and yelling at these Tea Party events” will win control of government. He added, “I don’t think you want the Tea Party running your community, running your family, running your government”:
JONES: Koch Industries has promoted awful environmental policies. They’ve been literally poisoning rivers, poisoning streams, and making money off of that. They’ve promoted now this awful economic idea that if you grow new industries in California you somehow hurt the economy. That’s nuts. And now they’re promoting bad politics by backing I think extreme movements in the United States. Here you have a bad actor, three strikes and you’re out. They’re bad on the environment in terms of their practices, they’re bad in terms of their economic philosophy they’re trying to shove down the throats of California, and they’re bad in their politics in terms of their supporting extreme political ideas in America. I think if you start connecting those dots, California voters are very sophisticated, and I don’t think any of them think the people who run Koch Industries wake up in the morning thinking how can Californians have better jobs? [...]
JONES: If you think things are bad now, what will happen when the people are screaming and yelling at these Tea Party events are actually in charge of your government, and in charge of your life, and in charge of your kids’ future? That is, maybe you have some hope fatigue, but you got a lot of reason to be fearful enough I think to stay involved and to get involved. I don’t think you want the Tea Party running your community, running your family, running your government.
As Jones states, Koch is not only corrosive to our politics because of its funding of angry and paranoid Tea Parties, but the company also manipulates the political system to pad its profits. For instance, Business Week reported on how Koch Industries used then-Sen. Bob Dole (R-KS) to try to suppress an investigation into Koch Industries’ massive theft of oil from Indian reservations. In another case, Koch Industries faced a $55 million civil suit for causing more than 300 oil spills over a five-year period. Again, Dole, a major recipient of Koch money and support, sponsored a bill that would allow Koch to easily defend itself from the oil spill charges. After Koch helped to elect George Bush in 2000, the Bush Justice Department abruptly settled a criminal case with $350 million in penalties Koch faced for discharging toxic chemicals from a refinery in Corpus Cristi, Texas.
Why is the “Kochtopus” flexing its muscle of campaign donations, Tea Parties, and front groups to enact the clean energy-killing Prop 23? In its corporate newsletter, Koch Industries explicitly states that the low carbon fuel standard California is set to adopt to comply with AB 32 carbon emissions regulations would harm its bottom line because Koch imports mostly high-carbon crude oil from Canada. Another Koch newsletter warns that its Pine Bend Refinery in Minnesota specializing in high-carbon Canadian crude would become much less profitable for Koch if low fuel standards mirroring AB 32 are adopted around the country.
Kevin Drum is “annoyed by the amount of time we all spend responding to the dumbest, most extreme forms of arguments.”
I don’t know. Sometimes I think that smart people actually spend too little time responding to the dumbest forms of arguments. It takes a certain kind of hubris to think that I’m going to persuade people who adhere to strong arguments that they’re mistaken. By contrast, I really do think I can persuade people that their bad arguments are wrong. You don’t want to waste too much time dealing with straight-up dishonesty, but plenty of well-intentioned people find themselves convinced by ideas that don’t withstand much scrutiny. And so I think there’s a case to be made for a kind of “discourse triage” where we attempt to purge the political system of the very weakest ideas as the preferred means of raising the level of debate.
The administration is always saying that the Affordable Care Act will encourage doctors and hospitals to provide care more efficiently and using various new demonstration projects develop ways of lower health care costs without sacrificing profits or rationing care. In today’s Fiscal Times, Merrill Goozner points to a program that’s already doing just that. It’s saving money by encouraging sick patients to take the steps necessarily to avoid repeat and unnecessary follow-up care:
A new study published this week in the New England Journal of Medicine claims there is a better way to engage patients that almost immediately achieves lower health care costs. The approach involves systematic telephone outreach to patients at high risk of serious health problems by trained nurses, who provide them with information about the risks and benefits of their therapeutic options.
A randomized, controlled study with nearly 175,000 participants found that the intervention lowered health care costs by 3.7 percent in the first year compared to those who didn’t get the calls or receive follow-up information. The main savings came from reduced hospitalizations – down 10.1 percent in the group receiving the intervention compared to those who received usual care. Pharmacy costs also fell by 3.6 percent. If this program reached the 160 million Americans with private health insurance, the savings could be huge – more than $10 billion in the first year alone.
In this model, the “staff targeted people considered at high risk of incurring new health care costs – people with chronic diseases like diabetes, chronic asthma, pulmonary disease and heart disease, for instance, or people recently discharged from the hospital.” The nurses made sure that the patients were going through with their prescribed treatments — thus forestalling more expensive complicaitons.
The staff also relied on “electronic medical records to identify patients considering such procedures as prostate, hip, knee, back or uterine surgery, and coronary revascularization” and provided them with “web links, video and print materials before the operation, comparing the risks and benefits of surgery with options like watchful waiting, bedrest, anti-inflammatory drugs and diet and exercise changes.” When fully informed, patients usually choose the less expensive and riskier treatment model.